'State getting 'F' from the CDC'

Sunday

Jan 27, 2013 at 6:00 AMJan 27, 2013 at 7:43 AM

By Craig S. Semon TELEGRAM & GAZETTE STAFF

With only a fraction of the money paid by cigarette manufacturers through a 1998 settlement agreement trickling down to local agencies, organizations and boards of health that battle nicotine addiction and smoking-related diseases, some anti-tobacco activists question why these efforts are getting shortchanged.

Joan E. Hamlett, director of the Central Massachusetts Boards of Health Tobacco and Alcohol Control Alliance, said the state's short-term budget cuts in tobacco education, prevention and programs will lead to increased long-term health care expenses.

“You're talking a $52 million program (in fiscal 1994) that got cut down to a $2.5 million program at our lowest funding point (in FY04),” she said. “Investment in tobacco control and prevention is pennywise and pound foolish because if you don't invest in it, you pay on it in the back end in significant health care cost.”

“The Centers for Disease Control (and Prevention) recommends that the state spends 35 percent of the master settlement on tobacco prevention efforts,” Ms. Hamlett said. “We were the leading state in the nation in tobacco control efforts and we now receive an “F” from the Centers for Disease Control.”

While the commonwealth is seeing the amount of youths smoking cigarettes going down, the use of other “attractive, cheap and easy to get” tobacco-flavored products including chewing tobacco and new dissolvable tobacco tablets are on the rise, she said.

In addition, advertisement links to these tobacco products pop up at popular youth's websites, she said. And, she said, that is why funding for tobacco education and prevention is desperately needed.

“We have already proven that through taxation and price point and eliminating all advertising, kids buying cigarettes at $9 a pack has significantly decreased,” Ms. Hamlett said. “If they do not access or attract the youth smoker, the tobacco industry goes under because the statistics show that 98 percent of people won't start smoking if they don't start by the age of 20. So adults don't wake up and decide to smoke. The average age of someone who decides to start to smoke is 13.”

To combat the public health problem associated with smoking-related illnesses, Massachusetts' voters approved in 1992 a referendum question calling for an increased excise tax on tobacco products, with about 40 percent of the revenues used to finance the Massachusetts Tobacco Control Program, administered by the Massachusetts Department of Public Health.

“The referendum's idea would be for us to get ourselves out of the job. But, until we can reduce the smoking rate to less than 5 percent, smoking will remain a public health issue,” Ms. Hamlett said.

“We were making great strides with the funding that we had. And, with these cuts, we're nowhere near that goal. We use the money extremely effectively for what is given to us in our program but we are not near that under 5 percent.”

Besides the Central Massachusetts Boards of Health Tobacco and Alcohol Control Alliance, the only other funded boards of health programs left in the area since the budget cuts is the Worcester Regional Tobacco Control Collaborative, which comprises 19 boards of health in Central Massachusetts. Worcester is the lead community.

As for the question of whether the state is doing enough in tobacco education, treatment and prevention, Derek S. Brindisi, director of Public Health for the city of Worcester, said we can always do more in our fight against tobacco.

“Smoking causes heart disease, which is the leading cause of preventable death. Until this changes, we must continue to address smoking and other tobacco-related products,” he said. “Additionally, there's a direct correlation between the falling youth access rates and the funding of programs that educate retailers and enforce the law.”

Mr. Brindisi said he feels the commonwealth should be using more money from the Master Settlement Agreement with tobacco companies and tobacco taxes for tobacco education, treatment and prevention.

Tobacco policy and education, he said, are the most effective ways to impact smoking rates.

The Central Massachusetts Tobacco-Free Community Partnership, a program of the Department of Psychiatry, University of Massachusetts Medical School — UMass Memorial Health Care, serves 69 communities. Funded by the Massachusetts Tobacco Cessation and Prevention Program, the Community Partnership serves as a resource for local coalitions, health and human service agencies, municipalities, and workplaces on tobacco intervention efforts.

Tina Grosowsky, project coordinator at the partnership, said she deals with a lot of communities that might not get state funding for tobacco programs.

“Of course, we believe we can always do more but it depends on the budget. And because the budget is so small it makes us, what the federal government calls, a minimum reach program statewide,” she said. “Massachusetts takes in about $800 million a year in funds from the tobacco settlement in 1998 but the tobacco prevention budget is about $4.1 million (in fiscal 13).”

Ms. Grosowsky said it is frustrating that the money that was actually supposed to be put aside for tobacco education, prevention and programs is not getting to the people who need it.

“All the rest of the money goes to the general fund of the state and none of it goes to any other health prevention at all. It all goes to roads and buildings and things the state uses for the money,” she said. “For every dollar that we spend in prevention for tobacco, cessation money, we save the state $2.”